Intervention for Anxiety After Falls

Falls are the most commonly occurring cause of traumatic injury among older adults. For
many, the consequences include reduced mobility, difficulty performing basic self-care,
social isolation, deteriorating health, or even death. Most interventions for falls do not
address anxiety in the aftermath of falling.

After an initial study assessment, participants will complete 8 home-based sessions of a
Cognitive-Behavioral therapy (CBT). The sessions will be led by a study clinician who will
cover the 5 intervention components:(a) education (learning about anxiety and the rationale
for treatment); (b) relaxation training (learning skills to reduce tension); (c) cognitive
restructuring (learning skills needed to cope better with distressing thoughts); (d)
behavioral activation (learning to initiate healthy activity); and (e) exposure (coaching in
how to confront avoided thoughts, situations, and people).

Participants will also complete assessments following completion of the intervention and 3
months after completion of the intervention.

Inclusion Criteria:

- age > or = 65 years

- English-speaking

- injured due to fall

- hospitalized

- returned home < or = 3 months

- ambulatory

- full or subsyndromal PTSD or Fear of Falling

- residing in one of the five boroughs of New York City

Exclusion Criteria:

- Inability to understand assessment questions

- Marked cognitive impairment

- Dementia

- Schizophrenia

- Bipolar Disorder

- Depression with psychotic features

- Delusional Disorder

- Substance Use Disorder or Dependence

- Active suicidal ideation, intent, or plan

- Active homicidal ideation, intent or plan

- Aphasia

- Acute or severe medical illness or life expectancy < 6 months

- Initiated psychotropic medications < 6 weeks prior

- Initiated mental health treatment < 6 weeks prior

- Psychosocial factors that would compromise study participation (such as not having a
telephone)